ADVANCING ACCESS TO ASSISTIVE TECHNOLOGIES

Andria Spindel, President & CEO, March of Dimes Canada

Established in 1951 to fund research in battle to end polio

Community-based provider of programs and services for Canadians with disabilities, their families, caregivers, employers and communities

Reaching up to 75,000 Canadians with disabilities annually

MARCH OF DIMES CANADA:A Brief Overview

v isionTo create a society inclusive of people with physical disabilities (seek board approval to tweak our vision statement to have complete alignment with our current reality)

missionTo maximize the independence, personal empowerment and community participation of people with disabilities

val uesTo provide solutions, through service, advocacy and research, which further equal opportunity, self-sufficiency, dignity and quality of life

MARCH OF DIMES CANADA:PROGRAMS & SERVICES Direct services provider

Employment Services Independent Living Services Community Engagement & Independent

Services Accessibility Services Conductive Education Stroke Recovery/Post-Polio Peer

Support Alternative Communication Services Recreation/Accessible Travel

Research & Advocacy

Home & Vehicle Modification Program

Assistive Mobile Technology Initiative

DesignAbility® Assistive Devices Program

Funded by Ontario Ministry of Community and Social Services to help people finance needed

home or vehicle modifications

National program providing tablets to people with physical disabilities to enhance their

community access and participation

Volunteers provide custom-built solutions and modifications to individuals who face

challenges due to mobility issues

Helps people with disabilities to acquire and maintain devices essential to their

independence

MARCH OF DIMES CANADA:ACCESSABILITY SERVICES

AD often funded include: Manual and power wheelchairs Scooters Replacement batteries Walkers Lower limb orthoses Home and bath aids Floor patient lifts Basic aids for daily living Repairs to existing devices

3460 applications

4126 devices funded

1847 consumers received devices

$2.24 million total service

value

$4.62 in additional contributions for every $1.00

contributed by MODC

MARCH OF DIMES CANADA:ASSISTIVE DEVICES PROGRAM

CHANGING NEEDS FOR A CHANGING POPULATION% of AD provided to individuals in

older age categories

Year N 65-75 75 +2011-12 1,025 23% 28%2012-13 1,139 23% 27%2013-14 1,389 24% 30%2014-15 1,421 28% 29%2015-16 1,674 29% 34%

An older population seeking AD is

reflected by data describing MODC

consumer population by

program

Aging, Disability and Technology A Framework for Research, Implementation & Policy

Purpose: To study how AD are accessed by Canadians and to examine the ethical, social, and policy issues around access to AD

Project Leads: Dr. R. Wang, University of TorontoDr. M. Wilson, McMaster Health Forum

AGING, DISABILITY AND TECHNOLOGY PROJECTJurisdictional Scan

Citizen Panels

Scoping Review

Stakeholder Dialogue

Completed

In Progress

Next Steps Recommendations Symposium Conceptual Framework

Key informantInterviews

Juris

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Citiz

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Stak

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• lRESULTS OF RESEARCH

Access to Assistive Technology in

Canada: A Jurisdictional

Scan of Programs

Canada wide scan of government and

charity AD funding and service programs for

adults

Panel Summary: Enhancing

Equitable Access to Assistive

Technologies for Older Adults in

Canada

Dialogue Summary: Enhancing

Equitable Access to Assistive

Technologies for Older Adults in

Canada

3 panels of 10-16 citizens share their

ideas and experiences on an issue, and learn

from research evidence and from the views of others

Convenes key leaders, policymakers and

researchers who are in positions to

champion system change to deliberate

on considerations

JURISDICTIONAL SCANData includes:

Names and jurisdictions of government and charity programs

Legislation associated with programs if applicable

AD covered under programs

Funding availability for AD and how funding system works

Availability and nature of AD services

Eligibility criteria for programs

Providers or authorizers for funding or services

Restrictions on AD that are provided

Over 250 government and charity assistive device programs across Canada

Access to funding varies by: Jurisdiction - fewer programs available in the Maritimes, Prairies and

the Territories Type of disability - mobility devices have the greatest coverage Eligibility criteria – e.g., disease specific, population specific

(Indigenous, RCMP, injured at work, post-secondary student) or different income assessments

JURISDICTIONAL SCAN -RESULTS

Funding arrangements can differ considerably (e.g. full funding, partial funding, short term rental, max. amounts, no funding – service only) Often there is need to apply to more than one program -coordination of benefits is needed The patchwork system is both inconsistent and overly complex -challenging to users, caregivers and healthcare workers

JURISDICTIONAL SCAN -RESULTS

JURISDICTIONAL SCAN -RESULTS

Mobility Communication Sensory

Cognitive Psychological

157 99 97

39 10

Icons made by Freepik and Icon Pond from www.flaticon.com

CITIZEN PANELS -PARTICIPANTSProfile of Participants Number of participants: 37Where were they from: Ontario, Alberta, Nova Scotia and New Brunswick Age 25-64 (59%); 65+ (61%)Male (51%); Female (49%)Has sought or used AD (57%); Caregiver to someone who has sought or used AD (38%); Never sought or used AD (43%)

AD not fairly allocated, access is complicated Challenges in paying for AD Lack of integrated approach to delivery of AD Stigma associated with AD Lack of accessibility standards and inaccessible public spaces

CITIZEN PANELS -RESULTSRecommendations

Support users, caregivers, and healthcare providers with tools to help in decision making

Guidance when accessing public and non publicly funded programs

Lack of collaboration between health systems and other sectors is a major barrier

What is needed to improve equitable access

Adopt common language, improve system navigation, and enhance access to individualized assessments

Better align government programs with user needs and coordinate public and private insurance to minimize gaps

Centralize and simplify approval, eligibility and assessment processes Implement a robust data collection and evaluation strategy

STAKEHOLDER DIALOGUE -RESULTS

Discussion on Next Steps Spreading awareness of AD Working with partners across health and social systems on data

collection and ways to evaluate new technologies Building capacity among overworked health professionals to support

provision of AD Exploring small-scale innovative projects designed to enhance

equitable access to determine what works

STAKEHOLDER DIALOGUE -RESULTS

Scoping ReviewWill Identify and map literature on ethical challenges related to AD access to inform policy development

InterviewsWill examine policymaker/stakeholder views on ethical, social and policy issues related to AD adoption and access, and solicit suggestions on how to address equity of access and service gaps

SCOPING REVIEW AND INTERVIEWS

Unique partnership is a strength Dissemination of research results to potential partners Build upon existing work

• Consultation with Canadians to solicit their values and preferences • Research evidence for AD outcomes • Insights from successful and unsuccessful policy and program models

within Canada and internationally • Deliberations with policymakers, charity organizations, service

provider organizations, &industry representatives

MOVING FORWARD

Goal: To act on key recommendations from national stakeholder dialogue which focused on the need to build and implement a vision for enhancing equitable access that includes priorities for short-incremental changes; and principles and a guiding framework for aspirational long-term

fundamental changes

Include national/provincial/territorial policymakers, researchers, managers, healthcare professional organizations, and other stakeholders providing AD, services or advocacy

MOVING FORWARD: PROPOSED ASSISTIVE DEVICE POLICY SYMPOSIUM

Access to Assistive Technology in Canada: A Jurisdictional Scan of ProgramsDaphne Schreiber, MODC Rosalie H. Wang, UofT Evelyne Durocher, UofT Michael Wilson, McMaster Health Forumagewell-nce.ca/wp-content/uploads/2015/09/age-well_jurisdictional-scan_2017_June-30_FINAL.pdf

Panel Summary: Enhancing Equitable Access to Assistive Technologies for Older Adults in CanadaCristina Mattison, McMaster Health ForumKerry Waddell, McMaster Health Forum Michael G. Wilson, McMaster Health Forum www.mcmasterforum.org/find-evidence/products/project/enhancing-equitable-access-to-assistive-technologies-in-canada?platform=hootsuite

Dialogue Summary: Enhancing Equitable Access to Assistive Technologies for Older Adults in CanadaKerry Waddell, McMaster Health Forum Michael G. Wilson, McMaster Health ForumCristina Mattison, McMaster Health Forumwww.mcmasterforum.org/find-evidence/products/project/enhancing-equitable-access-to-assistive-technologies-in-canada?platform=hootsuite

RESOURCES

Feel free to contactAndria Spindel, President & CEO March of Dimes Canadaaspindel@marchofdimes.ca

THANK YOU